Tricks of the Trade

I am looking for helpful hints to pass on to people, things that some people use everyday but not all people may know about.  Things like (disclaimer the ideas submitted may or may not work and in some cases might be dangerous, however funny, if you try them it is at your own risk)

Categories:

AIRWAY

  1. If you have to intubate a Victim of smoke inhalation, or known CO poisoning, or a dive accident, inflate the cuff of the tube with Saline.  If the patient has to go into a hyperbarric chamber a cuff inflated with air will shrink under pressure then the tube will dislodge.  If it is filled with saline it will not shrink.  Just be sure to mark the inflation tube that it is inflated with saline.

  2. WARNING THIS IS FOR EMERGENCIES ONLY!!!!!!!!!!! A 10 or 15 drop set for an iv makes a quick needle cric kit in a pinch.  Cut the tubing at the drip chamber.  it is the exact size as a BVM adaptor.  Use the needle end to do the Cric.  It is the equivalent of a 10ga needle and much shorter.

  3. To secure a ET tube use 1 in tape folded in half (so it is i/2 in tape).  Tie it off like string.  Then you woun't have to worry about long hair, vomit or whatever preventing the tape from sticking.

  4. A turkey baster as a cheap suction device for jump kits 

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BREATHING

  1. If you don't carry jet insulflators for Crics use a 3cc syringe and the adaptor from a 7.o ET tube attached to a BVM
     

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CARDIAC

  1. For NTG, using a straw to deliver the tablet under the tongue works well and prevents you having to put your finger in the patients mouth or explaining what "lift your tongue up" means (sadly this doesn't work for spray)

  2. if you are having trouble auscultating a B/P in a noisy environment-bite your back teeth together

  3. If you release the pressure slowly in a BP cuff watching the needle bounce will give you a ballpark BP if you can't palp the pulse or hear it.

  4. In the absence of an IV during a cardiac arrest, a butterfly needle stuck through the side of an ET tube gives a convenient way to inject the LEAN drugs without stopping ventillations (and without getting sprayed while trying to connect the bag back to the tube)

 

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DISABILITY

  1. try using syrup for diabetics.. Not sugar free. or Cake icing.

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DRUNKS AND EDP's

  1. cut a 10--12inch slit in a red bio--hazard bag and place it over the head of your unconscious drunk. when he vomits it doesn't go all over your rig and you can turn it over the ER staff for testing

  2. I DO NOT RECOMMEND THIS!!! (but it's funny) Hitting someone with a d tank leaves a mark and can lead to prosecution... hitting someone with a 1000 bag leaves no mark and can put someone in a world of hurt. that's for those patients that want to get a little unruly in your ambulance.

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EKG's

  1. Lead placement: Women(white)  Bleed(black) 
                                Red  some find it sick but it works

  2. Lead Placement:  White Right, Smoke (black) over fire (red)

  3. Lead Placement: Whoops Better Run (an EKG)

  4. Lead Placement: white (white), boys (black) run(red)

  5. Lead Placment: salt, pepper, ketchup

  6. For 12 lead AVInferior,  AVLateral (sorry nothing for AVF)

  7. PEA stands for "push Epi. asshole (not sure if this was meant for tricks of the trade but it works)

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EYES

  1. Try using a nasal cannula across the bridge of the nose along with normal saline to flush a pts eyes. You can actually connect the IV tubing to the cannula and set the flow to keep the eyes flushed.

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IMMOBILIZATION 

  1. A tongue depressor makes a good finger splint.

  2. Using a upside-down KED is great to  stabilize a hip or leg FX.

  3. A vehicle's viso works well as a short splint. 

  4. When lacking a splint, a Pillow, thick blanket or newspaper work well (or anything else rigid)

  5. A horseshoe roll when done right is the best head immobilizer and the least expensive (1 blanket 1 roll of tape).

  6. 1000 bags make dandy splints for flail chests (swathe them down)

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IV's

  1. A Kelly forcep makes a great IV hanger.  Attach it to the stretcher sheet, pt's shirt or whatever.

  2. If a student is having trouble learning IV's have them practice on IV tubing so they get the concept.  Then place a sheet over the tubing and have them do it that way.  This way they can see what they are doing and can get a feel for it as well. 

  3. For a pt who is hyperthermic wrap the iv tubing around a cold pack- For a hypothermic pt wrap the iv tubing around a hot pack.

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OB/GYN

  1. Now on to those harrowing OB calls. Here's a solution to what to do w/ the placenta??? (who really wants to hold THAT!!??). This works great. As you place your female (hopefully!!) pt. on the cot slide a trash or Bio-Hazard bag onto the foot of the cot as if you were trying to put the mattress in it. Be sure to leave yourself enough room to pull it open when needed. When the placenta makes its presence known just slide that puppy right on down the cot into the waiting bag and Presto! One bagged placenta for the ER. Looks sort of silly, but hey, it works!! 

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PATIENT REMOVAL

  1. ABC's stands for ambulate before carry (you would be amazed how many people forget this)

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PEDS

  1. For small children  On non rebreather masks carry scented markers and draw on the inside of them to help calm them down. Plus the scented markers smell better than the plastic smell.

  2. Attach O2 tubing to a bear or other toy for blow by.

  3. Blow by on a child use a adult mask taped to head block. Works great and won't scare the kid

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EVERYTHING ELSE

  1. A strip of 3 in tape on you thigh is good for quick notes.

  2. The best way to treat a charlie horse is to pull on toe with opposite hand- as you push down the knee.  

  3. Radio antennas work well for holding that roll of wide silk tape

  4. 2 shower curtain rings and a dowel rod make a cool tape holder to hang on the overhead grab-bar in the pt. compartment

  5. Note to Newbies: Not all people over the age of 50 are hard of hearing and or senile.

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Last Revised:05/25/05 13:39

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